Prevention of hepatitis B infection by hepatitis B immune globulin in infants born to mothers with acute hepatitis during pregnancy.

Eleven infants born to mothers with acute hepatitis B during the third trimester of pregnancy who were hepatitis B surface antigen-positive at delivery were treated with hepatitis B immune globulin within 24-48 h of birth. Five infants received one dose of hepatitis B immune globulin and 6 infants received a second dose at 1 mo of age. During the average 12.5-mo follow-up period, only 1 of 11 (9%) treated infants became hepatitis B surface antigen-positive and this individual developed acute hepatitis B at 9.5 mo of age and recovered. Twenty-four infants born to mothers with acute hepatitis B during the third trimester of pregnancy who were untreated served as historical controls. Of these, 17 (71%) showed evidence for hepatitis B infection and 15 (62.5%) became chronic hepatitis B virus carriers. This study shows that administration of hepatitis B immune globulin to infants born to mothers with acute hepatitis B is effective in preventing perinatal transmission of the hepatitis B virus. With the availability of the hepatitis B virus vaccine, the current recommendation is to give hepatitis B immune globulin to such infants within 24 h of birth, followed by three doses of the hepatitis B virus vaccine beginning soon after birth, and again 1 and 6 mo later.